1.Direct carotid-cavernous fistula in a Filipino female presenting with simultaneous orbital/ocular, cavernous and cortical symptomatology without history of trauma: A case report.
Paulo L. Cataniag ; Debbie Liquete ; John Harold Hiyadan ; Randolf John Fangonilo
Philippine Journal of Neurology 2020;23(2):22-29
Carotid-cavernous fistula (CCF) is a rare and dangerous neurological disorder that arises due to
an abnormal communication between the internal carotid artery (ICA) or the external carotid artery (ECA)
and their branches and the cavernous sinus. It can either be a direct fistula (high-flow with acute
symptoms) most commonly resulting from trauma (70-90%) or an indirect fistula (low-flow with insidious
symptoms) secondary to hypertension, atherosclerosis and collagen vascular disorders. The shunting of
arterial blood into the venous system leads to venous hypertension causing various clinical manifestations
depending on the venous drainage patterns and the shunt flow. Increased anterior, posterior and superior
venous drainage results to orbital/ocular, cavernous and cortical symptomatology, respectively. This paper
aims to present a case of 58-year old Filipino female with a 2-day history of sudden, severe headache,
vomiting and blurring of vision followed by decrease in sensorium and sudden proptosis and chemosis of
the left eye. Patient had no co-morbidities, history of trauma, surgeries, facial skin infections or prior
febrile illness. The left eye had exophthalmos, subconjunctival hyperemia, scleral edema/chemosis and
ocular bruit. Neurologic examination showed a stuporous patient with multiple cranial nerve deficits
(impaired direct and consensual pupillary reflex left, complete ptosis left, sluggish corneal reflex left,
impaired oculocephalic reflex left), right hemiplegia and meningeal signs. Cranial Computed Tomography
(CT) Angiogram revealed an acute parenchymal hemorrhage in the left frontotemporal lobe with
subarachnoid component, with engorged left cavernous sinus and dilated left superior ophthalmic vein.
Digital Subtraction Angiography (DSA) was done revealing a direct type of left carotid-cavernous fistula
with massive ICA shunting to the cavernous sinus, superior ophthalmic vein and inferior petrosal sinus.
The clinical and radiographic evidence were consistent with a Direct/Type A CCF. Unique in this case was
a patient with no history of trauma presenting with simultaneous orbital/ocular, cavernous and cortical
symptomatology – a clinical picture of CCF that has never been documented in any literature nor included
in any classification system. The presence of all three symptomatology can be explained by a direct/highflow fistula that resulted to increased anterior, posterior and superior venous drainage as documented in
the DSA. In addition, spontaneous intracranial hemorrhage in CCF is exceptionally rare and it is the most
daunting symptomatology of this disease. With that, this specific case may pave the way to a new
classification scheme and determine its corresponding treatment approach.
Carotid-Cavernous Sinus Fistula
;
Cavernous Sinus
2.Intraoperative Embolization of Dural Carotid-Cavernous Fistula: Case Report.
Sang Heup RYU ; Byung Yon CHOI ; Sung Ho KIM ; Jang Ho BAE ; Oh Lyong KIM ; Soo Ho CHO
Journal of Korean Neurosurgical Society 1995;24(12):1600-1608
Among the twenty-six carotid-cavernous fistulas(CCFs) admitted to Yeungnam University Hospital from Nov. 1985 to Apr. 1994, we managed successfully by a intraoperative embolization of the cavernous sinus through the superior ophthalmic vein in two cases, which were not occluded the fistula site by the percutaneous transarterial and transvenous embolization. We exposed the cavernous sinus epidurally through the pterional approach and embolized the cavernous sinus with Surgical through the small opening at the junction of the superior ophthalmic vein entering the cavernous sinus. The surgical results were excellent.
Cavernous Sinus
;
Fistula*
;
Veins
4.Cavernous Hemangioma of the Cavernous Sinus: A Case Report.
Kyung Hee NOH ; Won Jong YOO ; Mi Sook SUNG ; Hong Jun CHUNG ; Myung Hee CHUNG ; Hae Giu LEE ; Jeana KIM ; Kyu Ho CHOI
Journal of the Korean Radiological Society 2001;44(4):419-422
Intracranial extra-axial cavernous hemangioma of the cavernous sinus is a very rare vascular malformation. It usually appears as a round non-encapsulated mass with well-defined borders, mimicking meningioma. We describe a case of cavernous hemangioma of the cavernous sinus, including the radiologic imaging findings, and also review the literature.
Brain Neoplasms
;
Cavernous Sinus*
;
Hemangioma, Cavernous*
;
Meningioma
;
Vascular Malformations
5.A Case of Cavernous Sinus Thrombophlebitis Secondary toAcute Isolated Sphenoid Sinusitis.
Byoung Soo SHIN ; Sun Young OH ; Young Hyun KIM
Journal of the Korean Neurological Association 2000;18(6):783-785
Cavernous sinus thrombophlebitis may occur as a complication of infectious and noninfectious processes. Septic thrombosis of the cavernous sinuses is a serious life threatening condition, and most commonly follows midfacial skin infections due to Staphylococcus aureus. Isolated sphenoid sinusitis is a rare and elusive clinical problem, and it is an uncommon cause of cavernous sinus thrombosis. We report a case of cavernous sinus thrombophlebitis of spheoid sinusitis origin. A good result has been achieved with immediate medical measures and surgical drainage.
Cavernous Sinus Thrombosis*
;
Cavernous Sinus*
;
Drainage
;
Sinusitis
;
Skin
;
Sphenoid Sinus*
;
Sphenoid Sinusitis*
;
Staphylococcus aureus
;
Thrombophlebitis
;
Thrombosis
6.Traumatic Carotid-Cavernous Sinus Fistula in a Patient with Facial Bone Fractures.
Sang Soo YU ; Soo Hyang LEE ; Hyun Woo SHIN ; Pil Dong CHO
Archives of Plastic Surgery 2015;42(6):791-793
No abstract available.
Carotid-Cavernous Sinus Fistula*
;
Facial Bones*
;
Humans
7.A Case of Calvarial Cavernous Hemangioma.
Jin Yang JOO ; Yong Gou PARK ; Joong Uhn CHOI ; Sang Sup CHUNG ; Kyu Chang LEE
Journal of Korean Neurosurgical Society 1986;15(4):795-802
A case of calvarial cavernous hemangioma is presented. The tumor was located in the postero-parietal bone, which was expanded extra and intracranially. The tumor and the attached dura were excised en bloc after ligation of superior sagittal sinus which had been completely obstructed on angiography. The preoperative X-ray and operative findings are presented. The authors reviewed the previously reported cases.
Angiography
;
Hemangioma, Cavernous*
;
Ligation
;
Superior Sagittal Sinus
8.Diffuse Pachymeningeal Tuberculosis Presenting as Unilateral Cavernous Sinus Syndrome.
Jae Hyeok LEE ; Jin Hong SHIN ; Kyung Pil PARK ; Dae Seong KIM ; Kyu Hyun PARK ; Dae Soo JUNG
Journal of the Korean Neurological Association 2003;21(4):440-441
No abstract available.
Cavernous Sinus*
;
Dura Mater
;
Meningitis
;
Tuberculosis*
9.Chondroid Chordoma in the Cavernous Sinus: Case Report.
Won Chul NAMGUNG ; Hyung Shik SHIN ; Young Soon HWANG ; Sang Keun PARK
Journal of Korean Neurosurgical Society 2003;33(1):91-93
The authers report a case of chondroid chordoma in the cavernous sinus. The chondroid chordoma is an uncommon variant of typical chordoma(0.2% of intracranial tumors) and reported usual locations of the chondroid chordoma are clival, parasellar, intrasellar, temporal region, other skull base and extracranial areas. Reported cases of this tumor arising in the cavernous sinus is very rare. We report a case of cavernous sinus chondroid chordoma presenting with clinical symptoms by hemorrhage.
Cavernous Sinus*
;
Chordoma*
;
Hemorrhage
;
Skull Base
10.Carotid-cavernous sinus fistula accompanying facial bone fracture:report of a case
No Bu PARK ; Yeon Ho SEO ; Seon Hye MOON ; Yong Oh LEE
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 1993;15(2):100-104
No abstract available.
Carotid-Cavernous Sinus Fistula
;
Facial Bones